Abstract

Summary In kidney transplantation, timing of an initial acute rejection (AR) is correlated with a variable risk of graft loss. However, it is unknown whether the increased risk for graft loss because of AR is conditioned by impaired graft function. A total of 730 cadaveric kidney transplant recipients were retrospectively evaluated from 1994 to 2001. When AR occurred, the risk ratio (RR) for graft loss was strongly time‐dependent and increased, the later the rejection episode occurred. Compared with the reference group (no rejection) having an AR within 0–30, 31–365, or >365 days post‐transplant conferred a 3.1‐, 9.1‐ and 49.3‐fold risk for subsequent graft loss (P